What is a Kennedy terminal ulcer?

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Named for the nurse who discovered the condition, a Kennedy terminal ulcer is a type of bed sore identified by its rapid onset and breakdown of tissue as a result of unrelieved pressure causing poor circulation of blood, according to Bed Sore FAQs. Patients often die within 24 to 48 hours of developing a Kennedy terminal ulcer, and treatment is limited due to its rapid onset.

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Also known as pressure ulcers, Kennedy terminal ulcers are generally pear-shaped with an irregular border, and they typically develop on the sacrum, though it is possible for one to develop elsewhere, notes Excelas. A Kennedy ulcer may begin as a Stage II ulcer and turn into a Stage III or Stage IV ulcer within days.

A Stage II ulcer is an open wound that is typically tender and painful and may appear as a blister, shallow crater in the skin or as an abrasion, informs WebMD. A Stage III pressure ulcer is characterized by full thickness tissue loss, and though bone, muscle or tendon is not visible, subcutaneous fat may appear through the wound, states the National Pressure Ulcer Advisory Panel. A Stage IV pressure ulcer may spread into muscle, fascia, tendon or joint capsules exposing bone, tendons or muscles.

When a patient presents with no symptoms in the morning and develops a purple or black flat blister larger than a quarter within a day, this type of Kennedy terminal ulcer onset is known as the 3:30 Syndrome, explains Excelas. Patients often pass away within 8 to 24 hours when 3:30 Syndrome occurs.